The gallbladder can be affected by gallstones, formed by material that cannot be dissolved – usually cholesterol or bilirubin, a product of hemoglobin breakdown.

These may cause significant pain, particularly in the upper-right corner of the abdomen, and are often treated with removal of the gallbladder (called a cholecystectomy).

Cholecystitis, inflammation of the gallbladder, has a wide range of causes, including result from the impaction of gallstones, infection, and autoimmune disease.

Unlike elsewhere in the intestinal tract, the gallbladder does not have a muscularis mucosae, and the muscular fibres are not arranged in distinct layers.

This is formed by smooth muscle, with fibres that lie in longitudinal, oblique and transverse directions, and are not arranged in separate layers.

[6] A distinctive feature of the gallbladder is the presence of Rokitansky–Aschoff sinuses, deep outpouchings of the mucosa that can extend through the muscular layer, and which indicate adenomyomatosis.

[2] The outer layer of the fundus of gallbladder, and the surfaces not in contact with the liver, are covered by a thick serosa, which is exposed to the peritoneum.

By the end of the fourth week, the developing duodenum begins to spout a small outpouching on its right side, the hepatic diverticulum, which will go on to become the biliary tree.

[13] The main functions of the gallbladder are to store and concentrate bile, also called gall, needed for the digestion of fats in food.

[15] When food containing fat enters the digestive tract, it stimulates the secretion of cholecystokinin (CCK) from I cells of the duodenum and jejunum.

In response to cholecystokinin, the gallbladder rhythmically contracts and releases its contents into the common bile duct, eventually draining into the duodenum.

This is through the active transport of sodium and chloride ions[17] across the epithelium of the gallbladder, which creates an osmotic pressure that also causes water and other electrolytes to be reabsorbed.

For instance, a systematic review and meta analysis of eighteen studies concluded that cholecystectomy has a harmful effect on the risk of right-sided colon cancer.

Blocked bile accumulates, and pressure on the gallbladder wall may lead to the release of substances that cause inflammation, such as phospholipase.

An inflamed gallbladder is likely to cause sharp and localised pain, fever, and tenderness in the upper, right corner of the abdomen, and may have a positive Murphy's sign.

In the surgery, the gallbladder is removed from the neck to the fundus,[22] and so bile will drain directly from the liver into the biliary tree.

It is most commonly an iatrogenic complication of cholecystectomy — surgical removal of gall bladder, but can also be caused by other operations or by major trauma.

Biliary injury may lead to several complications and may even cause death if not diagnosed in time and managed properly.

[21] Cancer of the gallbladder can cause attacks of biliary pain, yellowing of the skin (jaundice), and weight loss.

Liver function tests may be elevated, particularly involving GGT and ALP, with ultrasound and CT scans being considered medical imaging investigations of choice.

[21] Other imaging options include MRCP (magnetic resonance cholangiopancreatography), ERCP and percutaneous or intraoperative cholangiography.

[35] Diseases of the gallbladder are known to have existed in humans since antiquity, with gallstones found in the mummy of Princess Amenen of Thebes dating to 1500 BCE.

[35] Stough Hobbs in 1867 performed the first recorded cholecystotomy,[37] although such an operation was in fact described earlier by French surgeon Jean Louis Petit in the mid eighteenth century.

[36] It was only in the mid and late parts of the twentieth century that medical imaging techniques such as use of contrast medium and CT scans were used to view the gallbladder.

[35] The first laparoscopic cholecystectomy performed by Erich Mühe of Germany in 1985, although French surgeons Phillipe Mouret and Francois Dubois are often credited for their operations in 1987 and 1988 respectively.

[39] In the Chinese medicine, the gallbladder (膽) is associated with the Wuxing element of wood, in excess its emotion is belligerence and in deficiency cowardice and judgement, in the Chinese language it is related to a myriad of idioms, including using terms such as "a body completely [of] gall" (渾身是膽) to describe a forward person, and "single, alone gallbladder hero" (孤膽英雄) to describe a lone hero, or "they have a lot of gall to talk like that".

[40] In the Zangfu theory of Chinese medicine it is an extraordinary Fu or yang organ, as it holds bile.